The Tattooed Connection: Nurturing Curiosity in Medicine

The note on my patient’s liaison form revealed an intriguing request: “Bernard is a special needs patient. He has lost his upper complete denture prosthesis. It needs to be replaced because his father finds him sad and would like to see him smile again.” When I first read this note, I was taken aback. It mentioned that Bernard was 63 years old, but I was surprised and somewhat moved that the request came from his father. I considered the possibility of an error. To my surprise, there was not. As I entered the waiting room, I saw Bernard sitting quietly, withdrawn, and lost in thought, accompanied by a caregiver. With a warm greeting, I introduced myself, but there was no immediate reaction from Bernard—no smile, just a distant and frosty first contact. Seated in the consultation chair, Bernard remained locked in silence. Despite my best efforts, he refused to open his mouth. I am accustomed to breaking the ice with even the most reserved patients, often using humor and energy to establish a connection. However, this time, nothing seemed to work. Bernard simply did not want to engage with me. He fidgeted in his chair, clearly wanting to leave. I felt perturbed, not just by my inability to initiate care, but, above all, by my inability to connect with him on a human level, especially when it appeared he was able to communicate. In that moment, we were on the brink of letting Bernard go without any intervention. But as Bernard rose to leave, something caught my attention—a fragment of what appeared to be a tattoo on his neck. I felt a genuine curiosity to know more about this tattoo. I had no idea where it would lead, but I was attempting simply to humanely connect with him. His caregiver confirmed, “Yes, it’s a butterfly tattoo.” “Could it mean that Bernard is capable of enduring something that may not be very pleasant?” I inquired. “Absolutely,” the caregiver responded. “Bernard loves butterflies, but, more importantly, he loves to draw.” In that moment, inspiration struck. I invited Bernard to return, encouraging him to sit back in the chair. I initiated a new conversation, focusing on tattooing and drawing. Surprisingly, Bernard’s eyes lit up, and a faint smile began to form, signaling a connection. He explained his passion for drawing and his affection for his tattoo. He shared that the tattooing process had not been too painful, and he had endured the sessions with determination. At that instant, I understood that this seemingly small detail would carry significant implications in the care process. I revealed my own fondness for drawing and showed Bernard the felt-tip pen with aniline that prosthodontists use in the mouth to define the surface of the future prosthesis during impression taking. This step can evoke a temporary tattoo and Bernard, upon seeing it, exclaimed, “I’ve never seen a pencil like that!” His toothless smile widened. With a deal struck—if we could work together on his prosthesis, he would receive the pencil as a reward—Bernard readily agreed. Subsequent sessions progressed smoothly, sometimes with the aid of nitrous oxide, but always in high spirits. When the time came for the final delivery, I was elated with the result. As promised, Bernard left the clinic with his double-lead pencil in hand. Above all, the impact of this initial connection between us on his engagement in the care journey filled me with a profound sense of accomplishment. What would have become of Bernard without this connection? This experience confirmed for me the importance of an authentic connection with the patient and serves as a vivid illustration of the profound beauty and complex nature of health care. A few days later, I received a touching letter from Bernard’s father expressing his gratitude: “I find the result of your intervention perfect. Bernard had no trouble adapting to his new aircraft, as he now views it as a normal part of his life. Physically, something has changed as well….”

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